CANGO POSITION STATEMENT on Rapid access to cancer medicines in New Zealand

Introduction

CANGO (the alliance of Cancer Non-Governmental Organisations) has adopted a position on improving the access to new cancer medicines and treatments in New Zealand. We call on this Government to urgently consider and implement changes for reasons of equity, evidence and deep concerns about the systemic underfunding of more effective cancer treatments. In our view, the existing decision processes disadvantage, delay or deny access to innovative treatments, such as targeted therapies and immunotherapy, that are now accepted abroad as the standard of care.

The Cancer Landscape

In 2018 more than 23,000 New Zealanders were diagnosed with cancer, of whom more than 9,000 are expected to die. Cancer is our biggest killer and causes 30% of all mortality in New Zealand.

Most cancer patients have no time to wait and many are dying prematurely because they do not have access to the right medicines at the right time in their treatment cycle. Many of these medicines are freely available in other OECD countries.

New Zealand ranks 19th out of 20 OECD countries for access to new medicines; just 23.5% of medicines registered between 2012 and 2017 in New Zealand have subsequently been reimbursed.

When comparing access to new medicines with Australia in the period 2011-20171, New Zealanders are severely disadvantaged:

24 new cancer medicines have been reimbursed in Australia but not in New Zealand

The approval process takes considerably longer in New Zealand (190 days longer on average)

One of Labour’s pre-election pledges was to provide world class cancer care and a swifter process for funding new innovative treatments like targeted therapies and immunotherapy that are the standard in comparable OECD countries.

Since being elected, the Government has confirmed cancer is one of its major health priorities, although New Zealand has not yet seen a commitment to world class cancer care demonstrated in policy, nor an increase in funding nor an alternative access programme to clear the backlog of cancer treatments still sitting on the Pharmac waiting list.

We need to do better for our most vulnerable.

Rapid Access Scheme for Cancer Medicine

Under the current PHARMAC model, new cancer medicines typically take 3 years to be assessed for funding and there is also a significant backlog of unfunded medicines. Clearly the current system is detrimental to the wellbeing of cancer patients and many are dying needlessly or dying sooner than they should.
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Public dissatisfaction with the lack of access many patients have to new medicines and treatment is growing – this has been demonstrated in public campaigns in the past for Herceptin (for breast cancer) and Keytruda (for melanoma cancer) and more recently in the petition presented to Parliament for Ibrance (again for breast cancer).

Additionally, media frequently report cases of patients needing to resort to funding schemes such as Givealittle to self-fund medicines and treatments that are available and funded in comparable OECD countries. Patients fortunate enough to have medical insurance rely on this to cover costs of their cancer treatment. We are fast becoming a two-tier society of “haves” and “have-nots” when it comes to cancer treatment increasing inequities in cancer care.
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CANGO believes this is unjust and the situation needs to be addressed.

CANGO supports the development of a Rapid Access Scheme for new and novel cancer medicines and treatments. Such a scheme in UK (their version 2) is very successful and provides a model of what could be developed in New Zealand.

Again, we remind this Government of its pre-election pledge to introduce a Rapid Access Scheme for new cancer medicines and treatments and offer our knowledge and experience across the cancer spectrum in working with Government to resolve this issue.

The group was formed in 2007 in an effort to increase collaboration among cancer charities and to advocate on behalf of cancer patients and carers.

Member organisations meet regularly to discuss key issues facing the sector; to meet and share information with representatives from the Ministry of Health and others working in cancer-related areas; and to work together on specific initiatives that reflect the shared goal of all members to reduce the incidence and impact of cancer on New Zealand and New Zealanders.

IQVIA Access to Medicines Report 2018 available from Medicines NZ

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